Assessing fibrosis-4-index (FIB-4), hepatic steatosis index (HSI), and triglyceride-glucose index (TyG) in relation to hepatic, inflammatory, and metabolic profiles in individuals with metabolic syndrome

Objectives: Metabolic syndrome (MS) is closely linked to metabolic dysfunction-associated steatotic liver disease (MASLD), highlighting the importance of recognizing hepatic and metabolic alterations in this population. This study aimed to evaluate the inflammatory and metabolic profiles of individuals with MS and to investigate the associations of the FIB-4, HSI, and TyG indices with hepatic, metabolic, and inflammatory parameters. Methods: A total of 67 individuals diagnosed with MS were evaluated at a university outpatient clinic. Participants underwent biochemical, hematological, hormonal, and inflammatory testing. Statistical analyses included Spearman's correlation, principal component analysis (PCA), and multiple linear regression, with significance set at P < 0.05. Results: Results showed that 85.07% of participants presented signs of hepatic steatosis based on the HSI index, despite lacking a clinical diagnosis. PCA and correlation analyses indicated that individuals without steatosis had mild glycemic and lipid alterations, whereas those with steatosis exhibited greater metabolic heterogeneity, with diferences in inflammatory and dyslipidemic profiles. The TyG index was significantly associated with insulin and HOMA-IR, supporting its association with insulin resistance. HSI correlated with AST, ALT, hs-CRP, and total proteins, indicating hepatic and inflammatory involvement. FIB-4, however, showed no significant associations. Conclusion: The TyG and HSI indices appear to be useful and accessible tools that may provide complementary information on metabolic, hepatic and inflammatory alterations in individuals with MS, whereas FIB-4 showed no significant associations in this population. These findings may contribute to identifying individuals who could benefit from further clinical assessment and early management of modifiable metabolic risk factors; however, prospective studies are needed to establish the diagnostic and predictive utility of these indices.